Abstract：
BACKGROUND: Human intestinal spirochetosis (HIE) is a poorly studied clinical entity with variable clinical manifestations. However, in recent years it has gained special relevance because an increasing number of cases have been described in people living with HIV (PWH) and in patients with a history of sexually transmitted infections (STI) or immunosuppression.
METHODS: Retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014 and 2021.
RESULTS: 36 Cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs. 28%; p < 0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%).
CONCLUSIONS: HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.
METHODS: Retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014 and 2021.
RESULTS: 36 Cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs. 28%; p < 0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%).
CONCLUSIONS: HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.
摘要：
背景：人肠螺旋体病（HIE）是一种研究很少的临床实体，临床表现各不相同。然而,近年来,由于在HIV感染者(PWH)和有性传播感染(STI)或免疫抑制病史的患者中描述了越来越多的病例,因此它具有特殊的相关性.
方法：回顾性审查在三级医院中确定的所有HIE病例（SphospitalUniversitariolaPaz，马德里）在2014年至2021年之间。
结果：共确诊36例HIE。大多数病例对应于男性（94％），中位年龄为45岁。10例（29.4%）为PWH，20例（56%）为男男性行为者。尽管临床表现非常异质，最常见的是慢性腹泻(47%)，高达25%的受试者患有临床直肠炎。在过去的两年中，有39％的患者被诊断出患有性传播感染。这一特征在PWH中更为常见(90%与28%；p<0.01）高于未感染HIV的患者。与HIE诊断最常见的STI是梅毒（31％）。
结论：HIE经常被诊断为其他性传播感染，并且主要影响与男性发生性关系的男性，这支持该实体可以被视为新的STI。
方法：回顾性审查在三级医院中确定的所有HIE病例（SphospitalUniversitariolaPaz，马德里）在2014年至2021年之间。
结果：共确诊36例HIE。大多数病例对应于男性（94％），中位年龄为45岁。10例（29.4%）为PWH，20例（56%）为男男性行为者。尽管临床表现非常异质，最常见的是慢性腹泻(47%)，高达25%的受试者患有临床直肠炎。在过去的两年中，有39％的患者被诊断出患有性传播感染。这一特征在PWH中更为常见(90%与28%；p<0.01）高于未感染HIV的患者。与HIE诊断最常见的STI是梅毒（31％）。
结论：HIE经常被诊断为其他性传播感染，并且主要影响与男性发生性关系的男性，这支持该实体可以被视为新的STI。
